Individual
COREY L THOMPSON
Active
Individual
COREY L THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
AZ 2069
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
384678
—
AZ
01
—
AW7564
AZ HEALTHNET
AZ
01
—
AZ0147940
AZ BCBS
AZ
01
—
HN3Z0381
AZ HEALTHNET
AZ
Enumeration date
07/18/2006
Last updated
12/22/2014
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